PERSA D CLARK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010870

License Status

NOT RENEWED

Business

First Name

PERSA

Middle

Last Name

CLARK

Business Name

PERSA D CLARK

Original Issue Date

02/11/2004

Effective Date

07/21/2015

Expiration Date

09/30/2018

City

LITHIA

State

Zip

33547

Ever Disciplined

LastModifiedDate

10/31/2018